A Clinical Experience with Perforator Flaps in the Coverage of Extensive Defects of the Upper Extremity

Traditional skin free flaps, such as radial arm, lateral arm, and scapular flaps, are rarely sufficient to cover large skin defects of the upper extremity because of the limi-tation of primary closure at the donor site. Muscle or musculocutaneous flaps have been used more for these defects. However, they preclude a sacrifice of a large amount of muscle tissue with the subsequent donor-site morbidity. Perforator or combined flaps are better alter-natives to cover large defects. The use of a muscle as part of a combined flap is limited to very specific indications, and the amount of muscle required is restricted to the minimum to decrease the donor-site morbidity. The au-thors present a series of 12 patients with extensive defects of the upper extremity who were treated between Decem-ber of 1999 and March of 2002. The mean defect was 2